By Landon Hall
The Orange County Register
Whites are surviving melanoma at much higher rates than decades
ago, thanks to public awareness and early treatment. The trend
hasn’t extended to blacks and Hispanics, however: Those groups
develop skin cancer much less frequently but tend to have more
advanced progression at diagnosis, according to a new study.
The research, which examined more than 41,000 cases of melanoma
diagnosed in Florida between 1990 and 2004, found that 12 percent
of whites had melanoma that had spread
”
regionally or to distant parts of their bodies
”
at the time of diagnosis, compared with 18 percent of Hispanic
patients and 26 percent of blacks.
By Landon Hall
The Orange County Register
Whites are surviving melanoma at much higher rates than decades ago, thanks to public awareness and early treatment. The trend hasn’t extended to blacks and Hispanics, however: Those groups develop skin cancer much less frequently but tend to have more advanced progression at diagnosis, according to a new study.
The research, which examined more than 41,000 cases of melanoma diagnosed in Florida between 1990 and 2004, found that 12 percent of whites had melanoma that had spread “regionally or to distant parts of their bodies” at the time of diagnosis, compared with 18 percent of Hispanic patients and 26 percent of blacks.
“This study adds to a growing body of literature that identifies a pervasive and persistent disparity in the stage of melanoma diagnosis between Hispanic and black patients vs. white patients,” reads an editorial in the journal Archives of Dermatology, which published the study.
The study revealed that diagnoses among white women and Hispanic women are rising faster than in other groups. Incidence of melanoma in white women increased by 3.6 percent per year during the 14 years examined, while rising by 3.4 percent among Hispanic women. Incidence in white men rose 3.0 percent, but for Hispanic men it was only 0.89 percent. The rates for black men and women remained relatively stable.
Melanoma, the deadliest form of skin cancer, develops in the cells that form melanin, the pigmentation in skin. Too much exposure to the ultraviolet rays of the sun, as well as tanning beds, greatly increases risk of developing melanoma. And as we now know, shade doesn’t fully block those UV rays.
The study’s authors, led by Dr. Shasa Hu of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, posit that Hispanics and blacks might put off seeing a doctor about melanoma lesions because they’re under the impression it’s a whites-only disease.
They’re mostly right, but not completely: Having darker skin is a “potentially protective factor” against melanoma, according to a 2006 USC study, using the state’s cancer registry. According to the National Cancer Institute’s online database, 28.9 out of every 100,000 white males are diagnosed with melanoma, and 18.7/100,000 for white women.
For Hispanic men and women, the rates are 4.7 and 4.6; for blacks, it’s 1.1 and 1.0. Overall, the median age at diagnosis is 59.
But the survival rate for whites has gone from 68 percent in the early 1970s to 92 percent in recent years, the study says.
“While it is possible that melanomas in different ethnic groups are distinct diseases, it is more likely that causal factors such as socioeconomic status, skin cancer awareness, and cultural and social values ultimately affect melanoma stage at diagnosis.”
Dr. Pat Lee, an associate clinical professor of dermatology at UCLA’s David Geffen School of Medicine, said the Florida study was relevant for Southern Californians. Not only are both regions sun-drenched, but they also have large Hispanic populations who may not believe they’re susceptible to skin cancer. This lack of awareness sometimes extends to doctors, Lee said.
“It doesn’t enter into peoples’ radars very often,” Lee said. “When you also put in the factor of late diagnosis and more advanced melanomas, you’re looking at access to medical care. Even if people have something they’re concerned about, they may neglect it because they don’t have health insurance.”
Lee says people should watch out for moles that grow larger, change color or begin itching or bleeding. For more on symptoms, click here. The National Cancer Institute urges a monthly “mole check,” and offers this online checklist for self-exams.
